Most people only pay attention to food and water safety when they’re in a developing country. Drinking bottled water and eating well-cooked food are essentials for any western tourist. But the problem is closer to home than you may think. Here in the US, 48 million Americans get sick with food poisoning every year. Astonishingly, FDA-regulated food calls have more than doubled in the past decade. Are the food industry’s safety regulations crumbling? Or has technology simply allowed us to trace outbreaks of food-borne illness better than we could before?

Since 2006, we’ve found E.coli, once thought to live only in meats, in bags of baby spinach, hazelnuts, and even cookie dough. We’ve found botulism in carrot juice and salmonella in peanut butter, ground pepper, jalapeño peppers, and pistachios. We’ve found hepatitis A in pomegranate seeds and Listeria in ice cream. It doesn’t matter whether you shop at Costco, Trader Joe’s, or Safeway. Food-borne illnesses are everywhere, according to the headlines at least.

Within the last few months, salads made by Dole killed four people and sent 33 more to the hospital. Within the last year, Chipotle’s notorious E.coli and norovirus crisis made national headlines and caused sales to plunge 16% in a single month. A 2015 study done by Robert Schartt, an associate professor at Ohio State University, estimates the annual cost of medical treatment pertaining to food-borne disease, lost productivity, and illness-related mortality at $55.5 billion. Now more than ever, people are getting food poisoning in a country that, for decades, has pioneered disease prevention knowledge and technology. So why are we having such a difficult time wiping out food-borne illness? There are three main reasons:

First off, discovering food poisoning outbreaks is much harder than it seems. Many who fall ill will not visit their doctor unless they experience extreme symptoms, and even then physicians don’t always order stool tests, the primary method used to detect harmful bacteria. As a result, very few people with food poisoning are ever formally diagnosed, making it almost impossible to deduce patterns of illness. Even when a doctor does find listeria, slamonella, etc. it’s still very difficult to pinpoint the guilty food or restaurant. A patient may have to supply a record of food consumption that goes back as long as 28 days. What are the chances a person will remember what she ate 4 weeks ago?

Another reason for America’s 55.5 billion dollar problem is that food companies don’t always cooperate with scientific efforts to curb outbreaks. While most companies test their products extensively, oftentimes those companies won’t release any of their research, inhibiting scientists and pathogen experts. In other words, even if a company is tracking bacteria and viruses in it’s products, keeping those test results secret makes it harder for scientists to gather information about these bacteria that could help prevent future outbreaks on a mass scale. Companies get nervous about sharing data for obvious reasons: they don’t want to give away evidence that could ever incriminate them in any way.

The third reason is that Americans love lots of food! In particular food that could never be grown in the US. We import about 20% of our food, and each country we import from has its own food-safety standards and inspection regimens, making the regulation and prevention of food-borne contamination in the global supply chain almost impossible. Every country your food goes through, the less safe it becomes. In one instance, by the time a batch of milk from China was identified as contaminated, it had already been exported to 47 other countries in the forms of various products.

Despite the three reasons given above, experts still seem to be in agreement that the rise in recalls and food poisoning cases is not a sign of poor safety standards in the food industry. Rather, the scientific community has simply gotten better at connecting disease with food and microbes. Now that we have the knowledge (or more knowledge) of how often our food makes us sick, we can start taking adequate steps to prevent food-borne illness.

One important step might be to improve the way companies interact with the FDA. For example, “Instead of the FDA having to show that firms are doing something wrong, firms have to show that they’re doing something right,” says Charles Breen, a former FDA district director who is now a food-safety consultant. Putting the pressure on companies to make food safety a top priority is one of the best ways we have to control outbreaks of food poisoning. Until then, we can achieve peace of mind to some degree with the knowledge that the rising number of outbreaks most likely means we are getting better at finding and tracing diseases—NOT that we live in a disease-ridden community.

While the media headlines may be more sensation than truth, food-borne illnesses have been all but eliminated from American Society. Until the food industry and food safety organizations like the FDA function more harmoniously, the burden falls upon consumers to know when its best to eat cooked food, use meat thermometers, and think about where we get our food in general—something we should be doing anyway for more reasons than just disease prevention.

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